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MedicaidPrior AuthLow impact

Kimmtrak (tebentafusp-tebn) (New)

Humana·LA · Oncology·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Days to comply

Summary

New prior authorization policy for Kimmtrak (tebentafusp-tebn) for Louisiana Medicaid patients with metastatic uveal melanoma. Requires specific HLA-A*02:01-positive disease documentation and must be used as monotherapy.

Action Required

Action needed
By December 1, 2025: Billing team must update prior authorization procedures for Kimmtrak (tebentafusp-tebn) for Louisiana Medicaid patients. Ensure documentation includes unresectable/metastatic uveal melanoma diagnosis, HLA-A*02:01-positive assay results, and monotherapy use confirmation before submitting claims. Claims without proper prior authorization will be denied.